MEDICARE: DR. ARTHUR KOPP M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	A88371	CA
2	2084A0401X	Addiction Medicine (Psychiatry & Neurology) Physician	A88371	CA

General Provider Information

NPI Number	:	1598977241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARTHUR KOPP M.D.

Provider Business Mailing Address
First Line	:	5855 GREEN VALLEY CIR STE 312
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90230-6969
Country	:	US
Telephone Number	:	310-721-9030
Fax Number	:

Provider Business Practice Location Address
First Line	:	5855 GREEN VALLEY CIR STE 312
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90230-6969
Country	:	US
Telephone Number	:	310-721-9030
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2007
Last Update Date	:	11/11/2014

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